Abstract:

Objective

To investigate the efficacy of anti-reflux mucosal ablation （ARMA） in treating reflux hypersensitivity （RH）.

Method

A retrospective analysis was conducted on the efficacy of 8 RH patients who received endoscopic ARMA treatment at Department of Gastroesophageal Surgery Department of Rocket Force Characteristic Medical Center from August 2022 to August 2023. The subjective relief of gastroesophageal reflux related symptoms， discontinuation rate of acid suppressant， postoperative complications， recurrence， and re treatment were compared before and after ARMA.

Results

There were 3 males and 5 females in this group of RH patients， with a mean of 53 years. The mean follow-up time after ARMA was 18 months， and the subjective relief rates of acid reflux， heartburn， and chest/back pain symptoms in postoperative patients were 72%（38， 10）%， 70%（50， 95）%， and 70%（25， 97）%， respectively. And the symptom scores were significantly lower than before surgery （all P＜0.05）. The postoperative discontinuation rate of acid suppressing drug was 87.5% （7/8）， and the satisfaction rate of therapeutic effect was 75% （6/8）.There were 2 cases of postoperative swallowing pain discomfort， 1 case of abdominal distension， and 1 case of upper abdominal pain， all of which were mild and relieved within 1 week after conservative treatment.There were no cases of postoperative dysphagia. There was 1 case of partial recurrence of symptoms and no cases of anti-reflux reintervention.

Conclusion

ARMA can alleviate the GERD symptoms in most RH patients， with a high satisfaction rate of efficacy and acid suppressing drug discontinuation rate. Postoperative complications are rare and mild. However， further research is needed to determine the more accurate safety and efficacy of ARMA.

Key words: Gastroesophageal reflux disease, Reflux hypersensitive, Argon plasma coagulation, Anti-reflux mucosal ablation, Anti-reflux mucosectomy